The article “Three-dimensional Enhanced Imaging of Vitreoretinal Interface in Diabetic Retinopathy Using Swept-Source Optical Coherence Tomography” by Adhi and associates discusses the utility of swept-source optical coherence tomography (SSOCT) in imaging vitreoretinal interface in diabetic patients. The authors have used a vitreous windowing method and motion correction algorithms for enhancement of vitreous imaging.
During their evaluation the authors note “blurring of certain features of the posterior vitreous,” which may have occurred owing to use of motion-correction algorithm on the dynamic vitreous. As the control group found vitreoschisis to be present in 27% of normal eyes, one is tempted to also contemplate the converse, that is, overestimation of vitreoschisis owing to the motion correction algorithm. Even during development of the algorithm used, it was noted that “motion can cause some areas of the object to be sampled multiple times during acquisition, while other areas may be unsampled.” Moreover, as the algorithm is based on a “per-A-scan basis,” utilizing multiple images to generate a low-noise image could may have resulted in a single mobile vitreous membrane being imaged at different A-scan locations. Although a minor concern, we mention it because the documented incidence of vitreoschisis in normal controls, as on scanning laser–based OCT, is considerably lower, around 7%.
Diabetic retinopathy has a higher prevalence of vitreoschisis, which was again confirmed in the current study. It is possible that the thick and adherent vitreous cortex in patients with diabetic retinopathy is unaffected by motion artifact, as against what appears to be the case with a normal population. Nevertheless, the current study and the technique of imaging employed opens up doors to a very exciting methodology that will find use in other retinal disorders involving the vitreoretinal interface.